Reduced atopic march risk in pediatric atopic dermatitis patients prescribed dupilumab versus conventional immunomodulatory therapy: A population-based cohort study.

Autor: Lin TL; Department of Dermatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; Ph.D. Program of Interdisciplinary Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Fan YH; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan., Fan KS; Division of Chest Medicine, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan., Juan CK; Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan., Chen YJ; Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan; Faculty of Medicine and Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: yjchenmd@vghtc.gov.tw., Wu CY; Faculty of Medicine and Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan; College of Public Health, China Medical University, Taichung, Taiwan. Electronic address: cywu4@ym.edu.tw.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2024 Sep; Vol. 91 (3), pp. 466-473. Date of Electronic Publication: 2024 Jun 14.
DOI: 10.1016/j.jaad.2024.05.029
Abstrakt: Background: Dupilumab effectively treats atopic dermatitis (AD); however, its role in halting the atopic march remains uncertain.
Objective: To investigate dupilumab's effect on atopic march in pediatric AD patients versus conventional immunomodulators.
Methods: This retrospective cohort study utilized data from the TriNetX US Collaborative Network (2011-2024). Pediatric AD patients (≤18 years) were categorized into DUPI-cohort (newly prescribed dupilumab) or CONV-cohort (prescribed conventional immunomodulators without dupilumab). After 1:1 propensity-score matching, we analyzed atopic march progression, defined by the incident asthma or allergic rhinitis (AR). Cumulative incidence was plotted using Kaplan-Meier, with risk assessment via Cox regression.
Results: The study included 2192 patients in each cohort. The 3-year cumulative incidence of atopic march progression was lower in the DUPI-cohort than the CONV-cohort (20.09% vs 27.22%; P < .001). The DUPI-cohort demonstrated significant risk reduction in atopic march progression (hazard ratio [HR] 0.68, 95% CI 0.55-0.83), individual asthma (HR 0.60, 0.45-0.81), and individual AR (HR 0.69, 0.54-0.88). Younger patients on dupilumab exhibited a greater risk reduction for atopic march progression and individual asthma, contrasting with the opposite age-related pattern for individual AR.
Limitations: Observational study.
Conclusion: Among pediatric AD patients, dupilumab was associated with reduced risk of atopic march progression compared with conventional therapies.
Competing Interests: Conflicts of interest None declared.
(Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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